You Are Not Broken

Age is just a number. We say it all the time. Do we actually believe it?
This week I sit down with Dr. Arnold Gilberg, MD, PhD — a psychiatrist with over 60 years of clinical experience and author of The Myth of Aging. Sixty years. Let that sink in for a second. He has watched mental health care go from something people hid to something people post about. And he has spent just as long studying what actually keeps people vital as they get older, and it is not what most of us assume.
We get into what a psychiatrist actually is (and how that's different from a psychologist or a therapist), why the shame around therapy has mostly disappeared since the 1960s but hasn't fully left medicine itself, and why he'd argue we're over-medicating a problem that often needs connection more than a prescription. Then we go somewhere I did not expect, his own path to becoming a rabbi, and what spirituality has taught him about the mind that medicine alone couldn't.
If you've ever felt "stuck," or assumed decline was just the deal you signed up for by getting older — this one's for you.
Dr. Arnold Gilberg, MD, PhD, is a psychiatrist with more than six decades of clinical experience and the author of The Myth of Aging. Over the course of his career he has treated patients through massive shifts in how our culture understands mental health — from the stigma of the mid-20th century to today's very different, more open landscape. He is also a rabbi, a path that grew out of his clinical work and shapes how he thinks about meaning, purpose, and healing. The Myth of Aging book
What We Cover
Psychiatry vs. psychology vs. therapy. What a psychiatrist actually does, how that role differs from a psychologist or therapist, and why the lines have blurred (and shifted) as the field has evolved.
From shame to normal. How therapy went from something you hid to something you casually mention at dinner — and why stigma still lingers inside the medical community itself, even as it's faded in the culture at large.
The culture of medication. Dr. Gilbert doesn't hold back on this one — the over-reliance on medication, what gets missed when a prescription replaces psychotherapy, and why informed consent about side effects matters more than most patients realize.
Body and mind are not separate systems. Why physical activity is one of the most underused tools in mental health care, and how movement changes the brain, not just the body.
Becoming a rabbi. Dr. Gilbert's own journey into spirituality, and how faith and religion show up as legitimate tools for emotional and mental well-being — not as an alternative to psychiatry, but alongside it.
Cultural shifts, real clinical impact. How broader acceptance of diverse sexualities and identities has changed what shows up in the therapy room and how mental health providers practice.
Connection is the treatment. Why trust between patient and therapist predicts outcomes more than technique — and what that means for how we should be evaluating "good" therapy.
The myth of aging, dismantled. Aging does not have to mean decline. Investment in physical, mental, and social health changes the trajectory — and it's never too late to start.
Midlife crisis, reframed. What's actually happening during a midlife crisis, and why it can be the opening for real change instead of just a cliché to laugh off.
Mindset changes your biology. The Harvard research on mindset and lifespan — and what it tells us about how much of "aging" is happening in our heads before it happens in our bodies.
Getting unstuck. Practical ways to turn a feeling of stagnation into an actual growth opportunity.
Community, movement, purpose. The three pillars Dr. Gilbert keeps coming back to for aging well — and why none of them are optional.

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Menopause conversations center on women. For good reason.
But what about the guy standing next to her?
Joe Warner and Rob Kemp wrote Burning Up, Frozen Out — the first real guide to perimenopause written for men. Not about fixing her. About understanding what's happening and showing up anyway.
We talk about why men are so in the dark on this. What actually helps versus what just feels helpful. And why this works better as a team sport.
In this episode:
The stereotypes that make menopause a no-go topic at home
Why communication breaks down exactly when you need it most
Small, low-effort ways men can actually support their partner
Men have their own midlife hormonal shifts too — sleep, stress, food, fitness
Why "support" means listening, not solving

Burning Up, Frozen Out book
Website
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Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠
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Menopause doesn't just happen to a body, it happens to a relationship. In this episode, Traver Boehm joins Dr. Kelly Casperson to talk about what's actually going on hormonally during perimenopause and menopause, and what that means for the partners trying to understand it from the outside.
Kelly breaks down the real difference between perimenopause and menopause (hint: most people are using these words wrong), what's happening biologically during the transition, and why the emotional and relational fallout is often just as real as the hot flashes. Then the conversation turns to men — what's shifting for them hormonally during this same midlife window, and how couples can actually talk to each other about all of it instead of quietly drifting apart.
This one's for the women in it and the partners trying to show up for them.
In this episode:
Perimenopause vs. menopause, where one ends and the other begins
What hormonal changes are actually doing to mood, sleep, libido, and connection
The emotional and relational ripple effects of menopause that no one prepares you for
Hormonal shifts in men during midlife, and why this isn't just a "her" conversation
How to actually talk to your partner about what's changing
Rebuilding pleasure and intimacy when everything else is in flux
Reminder: none of this is individual medical advice, discuss your own plan with your own clinician.
https://www.manuncivilized.com/
https://www.instagram.com/traverboehm
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Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi
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In this episode, Dr. Linda Bosserman shares her expertise on hormone therapy, addressing common misconceptions and highlighting the latest science supporting their safe use in women and men. Tune in to hear practical insights on hormone management, systemic and local applications, and how to advocate for your health.
Key Topics Covered:
The importance of precise language: specifying hormone types, routes, and doses
The safety and efficacy of vaginal estrogen in women with breast cancer
Debunking myths about hormones causing breast cancer: data from large studies
The potential of testosterone in improving neurocognition, libido, and overall health in women
The ongoing fight for FDA approval of female testosterone products
The role of systemic hormones in preventing cardiovascular disease
How to counsel patients on hormone-related recurrence risks
The significance of personalized, evidence-based hormone therapy for optimal aging
Insights from Dr. Bosserman's PhD in sex therapy and its relevance to sexual health
The systemic biases and misinformation perpetuated by media and outdated guidelines

Dr. Bosserman
Menopausal Hormone Therapy after Breast Cancer
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We're closing out the season with something different: a multidisciplinary breakdown of episode six of Heated Rivalry. Not a recap. Not a fan theory session. A real conversation about what the show gets right — and what it gets wrong — about male performance anxiety, queer identity, female arousal physiology, and the stories we tell ourselves about our own bodies.
To be clear: this isn't about hockey. It's about what happens when good storytelling accidentally becomes a teaching moment for sexual health.
What We Cover
Performance anxiety isn't in your head — it's in your nerves, arteries, and muscles. Erectile function is vascular and neurological before it's psychological. Medication, alcohol, dehydration, stress — all of it shows up in the body before it shows up in the bedroom. We break down why "just relax" is the least useful advice you can give a man who's struggling, and what's actually happening physiologically when performance doesn't match desire.
Shane's coming out arc, and why identity evolution isn't linear. The show doesn't hand Shane a clean, tidy arc — and that's the point. We talk about how culture, family history, and internalized norms shape the timeline of coming out, and why real identity work rarely looks like the movie version.
Communication is the actual plot device. Underneath the hockey, the drama, the trauma — the show works because the characters eventually say the thing. We talk about why authentic communication is the real special effect in any story about intimacy, on screen or off.
Behind the scenes: setting, production choices, small details you'd miss on a first watch — and yes, a detour into tentacle erotica as a case study in how sexual expression keeps evolving in media, and why that's worth understanding rather than dismissing.
Key Takeaways
Erectile response is biological first, emotional second — treat it that way.
Female arousal physiology doesn't disappear at menopause; it changes, and imaging confirms it.
Coming out stories are shaped by context, not just courage.
Good storytelling about sex requires vulnerability, not perfection.
Expanding your sexual literacy — even through fiction — is part of the work.
You are not broken. Your body isn't broken. And apparently, neither is prestige TV's ability to sneak real sex ed into a hockey drama.
Season two, see you soon.
— Kelly
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⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi
Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠
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